Asthma in Women, Asthma in Pregnancy (cont.)

Asthma attacks can be mild, moderate, or severe. Fortunately, they only rarely lead to death. Mild or moderate attacks may show up as coughing, chest tightness, or a wheezing (whistling type of noise) during breathing. Any one person can have any one or a combination of these symptoms.

Many people do not know that coughing by itself can be a symptom of asthma. In fact, asthma is one of the three top causes of chronic cough. Also, many people only experience symptoms of asthma with a viral respiratory infection, as during a bad cold. Alternatively, asthma may show up as a cough that occurs only during or after exercise.

In severe attacks, the woman feels short of breath, has trouble talking, and may notice retraction (sucking in) of the muscles surrounding the ribs. This is called intercostal retraction. Bluish nails or lips may signal lack of sufficient oxygen to the tissues due to severe asthma. The extreme respiratory difficulty can also cause the neck muscles to work harder. She may notice a very fast heartbeat.

The official diagnosis of asthma requires 3 things. First, episodes of symptoms suggesting blockage of air-flow (airflow obstruction) must be present. The obstruction must be at least partly reversible (it can respond to medication), and other explanations for the symptoms must be ruled out (2).

There is an asthma screening program occurring in convenient locations, such as malls and health fairs, that is carried out by the Nationwide Asthma Screening Program. More information on screening dates and locations is available (14).

Epidemiology: Who Gets Asthma? Is Asthma Different In Men and Women?

Among 5-24 year-olds, the risk of dying from asthma in 1993 was 1.5 times higher in men than women (2). Mortality from asthma in females in 1995 was 2.5 per 100,000, compared to 1.9 in males. 1998 American Lung Association estimates observed that asthma increased much faster in women than men, 42% vs. 81%, between 1982 and 1994.

In people aged 20-50, the ratio of women to men admitted to the hospital for asthma is 3:1 (2). In 1995, the rate of hospitalization for asthma in females was 22.4 per 10,000, vs. 16.5 in men (2). Women also had longer lengths of stay once admitted to the hospital, 4.1 vs. 3.2 days (2). It is thought that asthma may therefore be related to hormonal conditions. There is some research proof of this.

Asthma is more severe in women, especially in the childbearing years, than in men, and it may get worse during a woman's menstrual period, again suggesting a possible involvement of female hormones. Although asthma affects females more than males in general, during childhood the opposite is true (2).